| National Provider Identifier [NPI]: | 1629129820 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | SUZANNE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 TUCKAWAY POND LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLCHESTER |
| Zip Code Of The Provider | 054461123 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 789 |
| Number Of Medicare Beneficiaries | 526 |
| Total Submitted Charge Amount | 368383 |
| Total Medicare Allowed Amount | 83602.08 |
| Total Medicare Payment Amount | 62634.82 |
| Total Medicare Standardized Payment Amount | 64171.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 789 |
| Number Of Medicare Beneficiaries With Medical Services | 526 |
| Total Medical Submitted Charge Amount | 368383 |
| Total Medical Medicare Allowed Amount | 83602.08 |
| Total Medical Medicare Payment Amount | 62634.82 |
| Total Medical Medicare Standardized Payment Amount | 64171.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 513 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 247 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6343 |